Oxymetazoline

260.381

260.37

216-079-1

8VLN5B44ZY

DTXSID3040691

C61871

Crystals from benzene

R01AA05|R - Respiratory system|S - Sensory organs

2933290090

44.6

3.4

Solid

0.9822 (rough estimate)

181-183 °C

403.63°C (rough estimate)

215ºC

1.5800 (estimate)

5.15e-02 g/L

Oxymetazoline hydrochloride nasal solutions should be stored in tight containers at a temperature less than 40 deg C, preferably at 2-30 deg C; freezing should be avoided. Oxymetazoline hydrochloride ophthalmic solutions should be stored at 15-30 deg C. Oxymetazoline is probably degraded in the presence of aluminum and, therefore, should not be stored in aluminum containers.

1.8X10-9 mm Hg at 25 deg C (est)

LD50 orl-rat: 800 mg/kg TXAPA9 18,185,71

Henry's Law constant = 1.7X10-11 atm-cu m/mol at 25 °C (est)

pKa = 11.16 (tertiary imidazoline nitrogen); pKa = 10.87 (phenol) (est)

Hydroxyl radical reaction rate constant = 9.7X10-11 cu cm/molecule-sec at 25 °C (est)

II

6.1(a)

3249

SK1050000

STABLE IN LIGHT & HEAT, & IS NONHYGROSCOPIC /HYDROCHLORIDE/

P260, P264, P270, P271, P273, P280, P284, P301+P310, P304+P340, P305+P351+P338, P310, P320, P321, P330, P403+P233, P405, P501

H300

SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.

Nasal decongestant active ingredients. The active ingredient of the product consists of any of the following when used within the dosage limits and in the dosage forms established for each ingredient: ... Topical nasal decongestants: Oxymetazoline hydrochloride. /Oxymetazoline hydrochloride/|The Approved Drug Products with Therapeutic Equivalence Evaluations List identifies currently marketed over-the-counter drug products, incl oxymetazoline, approved on the basis of safety and effectiveness by FDA under sections 505 of the Federal Food, Drug, and Cosmetic Act.

Gilstrap LC, Little BB; Drugs & Pregnancy 269-75 (1992). Antihistamines, decongestants, and expectorants during pregnancy.|Smith MB, Feldman W; JAMA 269: 2256-63 (1993). Over the counter cold medications: critical review of clinical trials between 1950 and 1991.

|Danger|H300 (100%): Fatal if swallowed [Danger Acute toxicity, oral]|P260, P264, P270, P271, P273, P280, P284, P301+P310, P304+P340, P305+P351+P338, P310, P320, P321, P330, P403+P233, P405, and P501|Aggregated GHS information provided by 90 companies from 1 notifications to the ECHA C&L Inventory. Each notification may be associated with multiple companies.

In rats, the oral LD50 is 680 ug/kg and the subcutaneous LD50 is 1630 ug/kg. In mice, the oral LD50 is 4700 ug/kg, the intraperitoneal LD50 is 48 mg/kg, and the subcutaneous LD50 is 34 mg/kg.

If significant systemic absorption of nasal /or ophthalmic/ oxymetazoline occurs, concurrent use of maprotiline or tricyclic antidepressants may potentiate the pressor effect of oxymetazoline.|A case is described in which a 34 yr old man presented with severe hypertension, cardiomegaly, and congestive heart failure, presumably due to oxymetazoline hydrochloride, phenylephrine hydrochloride, and ephedrine hydrochloride, consumed in massive doses by an overuse of nasal decongestants and cough syrup. Coadamin chlorpromazine hydrochloride and trimeprazine tartrate may have contributed to the effects through anticholinergic and antihistamine properties. The patient was treated with furosemide and nifedipine. Signs and symptoms of heart failure quickly resolved and blood pressure dropped to 140/100 mm Hg. /Oxymetazoline hydrochloride/|Self-treatment of anaphylaxis due to a single 75 mg dose of ketoprofen is reported in a 39 yr old female patient who used 12 inhalations of an oxymetazoline nasal solution in each nostril to relieve the respiratory symptoms of the allergic reaction. Within min of using the nasal solution, the respiratory symptoms began to subside, and the patient slept through the night and consulted her doctor the next day.|Reported is a case of chronic hallucination in a 61-yr-old man associated with long term use of phenylephrine hydrochloride (Neo-Synephrine), and, more recently, oxymetazoline hydrochloride (Afrin) nasal preparations. Trifluoperazine hydrochloride (10 mg/day) was begun, nasal preparations were discontinued, and a combination of pseudoephedrine hydrochloride and tripolidine hydrochloride (Actifed) was given 2 times/day. The nasal obstruction gradually decreased and the symptoms of psychosis and anxiety were alleviated.

LD50 Rat oral 800 ug/kg|LD50 Rat sc 1100 ug/kg

Oxymetazoline is indicated for the topical treatment of persistent facial erythema associated with rosacea in adults. Oxymetazoline in the ophthalmic formulation is indicated for the treatment of acquired blepharoptosis in adults. When used in combination with tetracaine intranasally, oxymetazoline is indicated for the for regional anesthesia when performing a restorative procedure on Teeth 4-13 and A-J in adults and children who weigh 40 kg or more.

Adrenergic alpha-Agonists; Nasal Decongestants; Sympathomimetics|Adrenergic (vasoconstrictor); nasal decongestant|Oxymetazoline /ophthalmic/ is indicated for temporary relief of redness associated with minor irritations of the eye, such as those caused by pollen-related allergies colds, dust, smog, wind, swimming, or wearing contact lenses. /Included in US product labeling/|Nasal oxymetazoline is used for the relief of sinus congestion. /NOT included in US product labeling/|For more Therapeutic Uses (Complete) data for OXYMETAZOLINE (11 total), please visit the HSDB record page.

Intranasal use of oxymetazoline may occasionally cause systemic sympathomimetic effects such as hypertension, nervousness, nausea, dizziness, headache, insomnia, palpitation, or reflex bradycardia.|Intranasal administration of oxymetazoline may cause transient burning, stinging, increased nasal discharge or dryness of the nasal mucosa, and sneezing. Rebound congestion, characterized by chronic redness, swelling, and rhinitis, frequently occurs with prolonged use and may result in overuse of the drug. Prolonged use of nasal decongestant solutions should be avoided for these reasons.|The incidence of serious adverse effects is low in patients receiving therapeutic dosages of topical oxymetazoline hydrochloride.|Safe use of oxymetazoline during pregnancy has not been established. Oxymetazoline hydrochloride ophthalmic or nasal solutions should be used during pregnancy only when instructed by a clinician.|For more Drug Warnings (Complete) data for OXYMETAZOLINE (13 total), please visit the HSDB record page.

Oxymetazoline a adrenergic alpha-agonists, direct acting sympathomimetic used as a vasoconstrictor to relieve nasal congestion The sympathomimetic action of oxymetazoline constricts the smaller arterioles of the nasal passages, producing a prolonged (up to 12 hours), gentle and decongesting effect. Oxymetazoline elicits relief of conjunctival hyperemia by causing vasoconstriction of superficial conjunctival blood vessels. The drug's action has been demonstrated in acute allergic conjunctivitis and in chemical (chloride) conjunctivitis. Oxymetazoline is used in combination with tetracaine for local anesthesia in dentistry, which adds beneficial effects. The vasoconstrictor counteracts the vasodilatory action of the local anesthetic agent, thereby constricting dilated arterioles and reducing blood flow to the application area. Oxymetazoline induces vasoconstriction of both resistance and capacitance blood vessels on human nasal mucosa, reducing nasal mucosal blood flow.

Drugs that selectively bind to and activate alpha adrenergic receptors. (See all compounds classified as Adrenergic alpha-Agonists.)|Drugs designed to treat inflammation of the nasal passages, generally the result of an infection (more often than not the common cold) or an allergy related condition, e.g., hay fever. The inflammation involves swelling of the mucous membrane that lines the nasal passages and results in inordinate mucus production. The primary class of nasal decongestants are vasoconstrictor agents. (From PharmAssist, The Family Guide to Health and Medicine, 1993) (See all compounds classified as Nasal Decongestants.)|Drugs that mimic the effects of stimulating postganglionic adrenergic sympathetic nerves. Included here are drugs that directly stimulate adrenergic receptors and drugs that act indirectly by provoking the release of adrenergic transmitters. (See all compounds classified as Sympathomimetics.)

... Oxymetazoline /at an optimum strength of 0.025%/ was absorbed slowly into the eye: only 0.006% of the original drug concentration was found in the aqueous humors of rabbits 30 minutes after instillation; the balance remained primarily in external ocular tissues. Metabolic studies in rabbits indicated that excreted amounts of unmetabolized radioactive oxymetazoline in urine following drug administration were similar (23%) for the ocular and nasal routes of application. The proportions of oxymetazoline metabolite to unchanged oxymetazoline were constant for all administration routes tested.|Following intranasal application of oxymetazoline hydrochloride solutions, local vasoconstriction usually occurs within 5-10 minutes and persists for 5-6 hours with a gradual decline over the next 6 hours. Following topical application of oxymetazoline hydrochloride ophthalmic solution, local vasoconstriction usually occurs within minutes and may persist for up to 6 hours. Occasionally, enough oxymetazoline may be absorbed to produce systemic effects.

Oxymetazoline is a direct acting sympathomimetic amine, which acts on alpha-adrenergic receptors in the arterioles of the conjunctiva and nasal mucosa. It produces vasoconstriction, resulting in decreased conjunctival congestion in ophthalmic. In nasal it produces constriction, resulting in decreased blood flow and decreased nasal congestion.|The mechanism of action of oxymetazoline has not been conclusively determined. Most pharmacologists believe that the drug directly stimulates a-adrenergic receptors of the sympathetic nervous system and exerts little or no effect on beta-adrenergic receptors. Intranasal application of oxymetazoline results in constriction of dilated arterioles and reduction in nasal blood flow and congestion. In addition, obstructed eustachian ostia may be opened. Nasal ventilation and aeration are improved temporarily; however, rebound vasodilation and congestion usually occur to some degree. Following topical application of oxymetazoline hydrochloride ophthalmic solution, conjunctival congestion is temporarily relieved, but overuse of the drug may produce rebound hyperemia.

/VET:/ Decontamination may not be practical due to the rapid absorption and onset of clinical signs. Heart rate and rhythm and blood pressure should be assessed, and an ECG obtained if needed. IV fluids should be given, along with atropine at 0.02 mg/kg, IV, if bradycardia is present. Diazepam (0.25-0.5 mg/kg, IV) can be given if CNS signs (eg, apprehension, shaking) are present. Serum electrolytes (ie, potassium, sodium, chloride) should be assessed and corrected as needed. Yohimbine, which is a specific a2-adrenergic antagonist, can also be used at 0.1 mg/kg, IV, and repeated in 2-3 hr if needed. /Imidazoline decongestants/

/SIGNS AND SYMPTOMS/ Excessive dosage and/or prolonged or too frequent intranasal use of oxymetazoline may irritate nasal mucosa and, especially in children, cause adverse systemic effects. Excessive dosage or inadvertent ingestion in children may cause profound CNS depression, possibly necessitating intensive supportive care. CNS depression, shock-like hypotension, and coma have occurred following overdosage of naphazoline and tetrahydrozoline; the possibility that this may occur with oxymetazoline should be considered.|/CASE REPORTS/ In this incident, oxymetazoline nasal spray 0.025% was administered to a 2-year-old patient during general anesthesia for nasal endoscopy. Severe hypertension with reflex bradycardia progressed to sinus arrest and was successfully treated with atropine and cardiopulmonary resuscitation.|/CASE REPORTS/ A patient prescribed oxymetazoline hydrochloride nasal drops presented with recurrent ventricular tachycardia of fascicular origin. Cardiac ultrasound showed a calcified lesion, presumably a fibroma arising from the interventricular septum. Fascicular tachycardia related to the lesion and provoked by the use of a sympathomimetic agent is postulated.|/CASE REPORTS/ Oxymetazoline is a sympathomimetic amine found in over-the-counter nasal decongestants. A case of chronic use of nasal oxymetazoline associated with thunderclap headache due to reversible segmental intracranial vasoconstriction /is reported/.|For more Human Toxicity Excerpts (Complete) data for OXYMETAZOLINE (11 total), please visit the HSDB record page.

Hydrochloride, Oxymetazoline

Nasal: Solution: 0.05%* Afrin ( with benzalkonium chloride, povidone, and propylene glycol; with or without menthol and regular drops and spray), (Schering-Plough), Afrin No Drip Extra Moisturizing 12 Hour Pump Mist ( with benzalkonium chloride, benzyl alcohol, glycerin, and povidone), (Schering-Plough) Afrin No Drip Original 12 Hour Pump Mist ( with benzalkonium chloride, benzyl alcohol, and povidone), (Schering-Plough), Afrin No Drip Severe Congestion 12 Hour Pump Mist ( with benzalkonium chloride, benzyl alcohol, povidone, and propylene glycol), (Schering-Plough) Afrin No Drip Sinus 12 Hour Pump Mist ( with benzalkonium chloride, benzyl alcohol, and propylene glycol), (Schering-Plough), Dristan 12 Hour Nasal Spray ( with benzalkonium chloride and benzyl alcohol), (Wyeth), Duramist Plus 12 Hour Nasal Decongestant Spray ( with benzalkonium chloride), (Pfeiffer), 4-Way 12 Hour Long Lasting Spray ( with benzalkonium chloride and phenylmercuric acetate), (Bristol-Myers Squibb), Nasal Decongestant Maximum Strength Spray ( with benzalkonium chloride, povidone, and propylene glycol), (Taro), Neo-Synephrine 12 Hour Extra Moisturizing Spray ( with benzalkonium chloride, glycerin, and phenylmercuric acetate), (Bayer), Neo-Synephrine 12 Hour Long Acting Spray ( with benzalkonium chloride and phenylmercuric acetate), (Bayer), Nostrilla12 Hour Nasal Decongestant ( with benzalkonium chloride; with metered pump spray), (Insight), Vicks Sinex 12 Hour Nasal Decongestant Spray ( with benzalkonium chloride and with regular or metered pump mist spray), (Procter & Gamble).|Ophthalmic: Solution: 0.025% Visine L.R. Eye Drops (with benzalkonium chloride), (Pfizer).|Trade names: Ocuclear Eye Drops (Schering), Visine L.R. Eye Drops (Pfizer) /Oxymetazoline hydrochloride/

PATENTS: GERMAN PATENT 1,117,588 (1961 TO E MERCK).|Available commercially as the free base or hydrochloride.

SPECTROPHOTOMETRY, GENERAL SAMPLE. AMERICAN PHARMACEUTICAL ASSN FOUNDATION, J PHARM SCI 55, 956 (1966).|IDENTIFICATION OF OXYMETAZOLINE BY GAS CHROMATOGRAPHY.|HIGH PRESSURE LIQ CHROMATOGRAPHY USED IN ANALYSIS OF OXYMETAZOLINE.|Analyte: oxymetazoline hydrochloride; matrix: chemical identification; procedure: infrared absorption spectrophotometry with comparison to standards /oxymetazoline hydrochloride/|For more Analytic Laboratory Methods (Complete) data for OXYMETAZOLINE (14 total), please visit the HSDB record page.

Pharmaceuticals